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tv   Key Capitol Hill Hearings  CSPAN  November 6, 2013 2:00am-4:01am EST

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care system that everyone on this committee agrees is broken, there are going to be some and some will lose, and frankly, under any reform plan that has been debated in the last 20 years, that is true. what we are suggesting is that there are going to be far more people over the course of the rollout of this legislation who have a better experience than what is happening currently in the system the band have a worse experience. tole it is always risky legislate by anecdote, we are telling stories here today, so let me just add one to the mix. betty berger from connecticut. betty and her family had insurance. jobs andnd switched during the several week period in between his first job and his second job, their son was diagnosed with cancer. guess what? his new employer would not pick up coverage for the son.
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betty's story is one that can be repeated 2 million times every single year across the country. they went bankrupt. they lost their house. they lost their car. they lost their savings simply because their son had the misfortune of being diagnosed during a two-week period in which they did not have insurance. was not that they got dropped from coverage, their problem is they could not find any coverage, and the story can be told millions of times over. and i guess my confidence that in the end --while this is a disruption to a large section of the economy, my confidence that in the end there are going to be far, far more winners than losers, is rooted in part in connecticut by shakespeare and. we have an exchange that is up and working. in the first month of the exchange, we have hit 10% of our evenll enrollment goal,
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given the fact that the massachusetts connector, who is run by the same guy who was running connecticut's exchange in the first month only so 0.3% of total enrollment sign-up. so, i have confident that the rocket will fly off the shelves once people can get into the website -- this product will fly off of the sale -- shelves once people can get into the website because what we have seen in connecticut and also i am optimistic that once his site is up it will be up in time for the largest number of people to inoll, because what you said response to senator bennet's questions, the reality is that the vast majority of people are going to be looking for coverage as the enrollment date draws near. so, i guess that is the frame of my question to you. from the experience of people who have been able to access these exchanges -- either at the national level or state level -- what do we know about the quality of the product and, two,
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what do we know about the timing of when people actually sign up for plans like this? we have the massachusetts experience, the experience of medicare part d. to the extent your timeline plays out and we have a fully functioning website within the next dirty-60 days, is that in time for what we expect to be the majority of people coming in and wanting to access the product? >> let me start with the product. i think that we are extremely pleased with the product. and i think it is important not to lose sight of that. as i said before, we had about 25% new entrants into the market, new issuers offering new plants. we had over 200 issuers and i think) 3000 products. but i will get you that specific information. -- the insurance market wants us to succeed. they see it as a the business. so, we have been pleased with the states in the competition.
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there have been some exceptions as we talked about before, and we want to stimulate that as time goes on. the second piece -- we have always believed that the first enrollment surge would come mid- december and the second surge would come late february/early march. there would be people who want to sign up by january 1, but there would always be another group who would wait until the last minute to sign up. presumably the younger, healthier folks who would wait until it became an issue for them. so, that is what we believe. the product is very strong. we would like to see more competition. that will occur year to year. this is our first year in the market. but we have been pleased, and in fact, the pricing came in about 18% below what the cbo estimates were. and we would like more introduction in some markets, for sure. but a good start. >> thank you. >> thank you, senator.
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senator berger? >> welcome. last week in your time in the house, you noted that as insurance companies decided to cancel and stop plans, the aca did not force insurers to make such decisions. you stated -- and i quote -- the issuer has decided to change the plan. not have to. grandfathered in 2010 if it -- if they did not make significant changes. they could keep the plants they had. do you believe that that was an accurate statement you made? do you believe that was an accurate statement? >> yes, i do believe that. force aca did not insurers to make such decisions. "the insurer decided to change the plan, they didn't have to."
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>> can i finish my sentence. >> this will not increase cost sharing. >> they were allowed to make modest changes to benefits modest increases in fixed dollar copayments and deductibles. if health care costs went up, they could move up. they can modify their provider network, they could change the plan structure to add features like health reimbursement accounts. >> for an insurance product that did not meet the minimum coverage benefits that was a .stablished under the aca >> they could be grandfathered in under this, yes. >> but, the decisions that are made if they don't meet the minimum benefit that was established under the aca, that
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is an individual that will have the plan canceled, is that not correct? >> they can continue these plans, these plans could be grandfathered in it they made these kinds of changes, if they started to reduce benefits, then they fell under the requirements of the aca. share you personally with the secretary that there were problems with the exchange? >> i personally shared with the secretary in september that there was modest changes. >> we have had a lot of conversations on security. let me ask you very specifically, was there ever any and two and testing on the exchange? >> there was and to and testing on the hub. there was individual modular testing and demonstration testing inside the exchange meaning that we had sample cases, sample situations that we
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tested all the way through. we could not test live until we went live, therefore the temporary authorization -- signed on september 27, the authority to operate the noted this.the memo from a security perspective, the aspects of the system that were not tested due to the ongoing development exposed the level of uncertainty that can be deemed as a high risk for federally facilitated marketplace systems. did you bring that security concern to the secretaries attention and the attention of the omb? >> i did not. >> secretary stability us said that the implementation took place on october 1 because that was the law. have read the asked several
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times. my interpretation is that secretary stability us had the authority not to execute that on october 1. clearly, my interpretation, if you had not signed the authority to authorize the website, it would not have stood up on october 1. >> i don't know if your statements are accurate. law says that january 1 is when individuals have to have coverage. we put a recommendation in place that said that october 1 would be what we would put in so people had time to sign up. theo you think that secretary had the authority to waive this? >> i do not know the answer to that question. >> is it true that individuals that were enrolled after march 23, 2000 10 are not eligible for grandfathered plans?
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that question again. >> is it true that individuals who enrolled in health care plans after march 23, 2010, they are not eligible for grandfathered plants? >> that is true. >> do you think that americans should have the ability to keep their plan? >> i think individuals that we talked about in the grandfathered plan should be allowed to have that happen and then large employer plans were grandfathered as well. i think we tried to look at the individuals and who to grandfather. >> thank you. -- tor franken >> thank you for convening this hearing. like my colleagues, i am frustrated and disappointed that a month into the open enrollment, there's still
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problems with the federal marketplace. i appreciate your being here today. i think it is important that we understand what we're doing to to fix the problems that have hindered comparison-shopping and enrollment over the past month. my number one priority is to see to it that people of minnesota have access to our state run marketplace, that that access is protected. things seem to be going better. this is with the minnesota health insurance marketplace, then with it has been going better and a lot of states. thousands of individuals and families are completing applications for comprehensive and affordable health coverage. it was developed and
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operated by minnesota, it does rely on the federal hub for its eligibility determinations and this was a problem that we had very early on. we were getting people to be verified. also, when the hub is taken off- also go off-st line. what are you doing to make sure that minnesotans can continue to enroll in the health plans through our state run marketplace while is undergoing maintenance? >> in the case of the hub, there has been very little downtime of the hub itself. we do have a window that we had agreed to prior to going live with the system. there are certain components
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such as social security which is during that time. the hub has worked flawlessly. andas not been the issue certainly the minnesota state- based exchanges doing well and they have access to the hub. when we are going to schedule down time, we let states know ahead of time. this is a that we can plan accordingly. .> the hub did not work this was the first week. >> this is not the problem. we had these been established at the federal level. i think that minnesota has more problems. all behind us. they were not hub issues. >> these are almost separate from health care. it has been working a lot
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better. one of the critical elements of success to the state run market changes will be clear communications. do you have open lines of communications with the states, they are operating about the challenges that they are facing and interacting with >> yes, we have daily commute haitians and we have teams assigned to work with states. or two, we doek either a videoconference or we call the states. we have very open lines of communications with states. >> there has been a number of andtions about security private information. i am chairman of the judiciary
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committee. i spent a lot of time working on protecting privacy. to me. very concerning can you tell me what you are doing now to make sure that issumers health information securely protected? >> we are meeting all of the standards, we do continuous security testing. i have kind of walk through those. we have a dedicated security team, we also do independent security analysis. this is continuous. we treat their marketplace, the same way we would treat any other system. these are inherently high risk. , i am doingr reports about the high risk of these natures. high riskt as a system and we monitor it continuously. we have a team dedicated to
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report on it and make us aware of it right away. >> my time has expired, thank you. >> thank you, senator. >> i have two questions. we see a tale of two beltway bandits. who is the ceo of cgi? >> michael roach is the ceo of cgi global. >> my guess is from what information you have, you have donated up to $140 million for him to do this work? >> current spending is 400 million including cgi. this includes qssi.
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in such a sneaky way? why refuse to provide the contract to congress? i am from chicago where we always kind of follow the money. if i cannot find out where it >> i am happy to go back and check. a lot of information has been provided to congress. >> so, you will be able to provide the contract to us? >> i will get you everything i can, yes. >> don't you have money missing that has not been paid? my understanding is that there's about 100 million to go. after a disaster of this nature, is there a way to have accountability with the remaining funds? >> i will get back to you with that information. >> maybe he can skip a holiday in the bahamas.
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>> it appears you're going to inflict this on the people of illinois where media reports tell us of upwards of 30,000 residents might lose their health insurance because of this program. i think a story was just run, about 3.5 million americans will lose their health care because of this program. i'm not sure that is accurate. i think you're referring to cancel policies. >> i'm referring to the story. >> i don't know which. there are not 3 million people losing coverage. >> are you accountable for the taxpayers funds? >> i think i am. >> hundreds of millions of dollars. for michael roach, i would think that you have provided a
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substantial wealth to him. that i just point out think we ought to know the full details of the contract that you have signed with him. i thinks i'm wrong, you have statements of worth, you have a lot of information already, but i will get you anything else. >> i would go to the other ceo of qs as i've. i which is to thinking about a phone call that might have happened when you were ready for this hearing. tangois carol, whiskey fang f on my website. >> what? yeah.,
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hundreds of millions of dollars, you should have something. mr. roachnder what is driving right now. probably something really nice. >> mr. chairman, i yield back. senator hagan.e, >> thank you, mr. chairman. thank you for being here. let me just ask about the december contingency planning. at the end of this month, either one or two things will be true. either the website will be working smoothly for the vast
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majority of its users or it won't. in both cases, the administration will have to take quick action to ensure that individuals across the country are being treated fairly. i am sure that people are planning for this at the end of the month. if the site works, individuals enrollve two weeks to in up land that will take effect on january 1. is the administration planning and outreach strategy to match this surge that is currently underway? if the site is not working, then what steps is the administration going to take including delaying the penalty or not buying insurance. and then what will they do to the individuals to make sure that there will not be a gap in their insurance coverage? a publicere is
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campaign that will match, the end of november and going into december, january, february, march. there are no plans to delay the individual mandate. what if the site is not working? >> the site will be working. the site is working now. we are making it performance improvements. >> are enough people able to get on the side? >> do you have numbers? >> we had over 700,000 who have completed applications. we will have mid november through october. >> they are waiving penalties for two months to make up for the lost time that it is taking getting the site up and running.
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anhink that that will be issue. one of the things i was concerned about him leading the the contracts to award this site. was it really awarded to companies that had been on an i.t. contractor that was back in 2007? was it not open to other companies? >> it was a contract which back in 2007, there was a list of vendors to do this kind of work. >> a lot has changed from 2007 until now. >> these are current vendors. the ir.ess was
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>> if you are not on that contract, would you not be eligible? >> that's right, you would not be eligible. this process was completed in 2007. it is been used for projects. it is a series of contractors who have been prescreened, prequalified. aey still are going through competitive bid process. this still is for the individuals that qualify in 2007. >> are those companies, would they be on that qualifying contractors? look at theave to individual side of this, certainly. on september 30, the night before the site was set to launch, what were your
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expectations for the launch day? >> that is a great question. wefirst expectation is that would go live shortly after midnight because we were doing a soft launch at midnight. we had pretty much promoted that the site would go live at 8 a.m. the normal cost them morning of october 1. we went shortly after midnight. we had tremendous interest, even during the night. my expectation was that it would work, it would have the customary glitches. it is a complicated website. bugs.w that it would be we had to pull functionality out to spend more time focusing on the application process. what i expected was a site that worked with some issues.
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more volumewas than we anticipated and we anticipated pretty high volume and then we ran into the issue with the establishment the e- mail accounts. to problem solve for that. those were two things we did not expect. >> it seems to the information i have been reading was that there was warning before the site went open. was a lot of concern that testing had not been done. in hindsight now, a lot of people are saying, why didn't the administration give the sitewarning about not living up to the expectations that was being called for and many people understood that it would be up and running and being able to access it quite easily? >> i would say that the testing
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around the hub was complete and i think the testing that had not been finished was testing in a live environment. , in ourour analysis modular testing, we had done independent verification him if that had passed security checks. we were comfortable and we did not have any high risk recommendations. we cannot do the the live into and testing. we did case testing prior to that. >> thank you very much, senator. >> i wasn't watching my clock. i apologize. >> the navigators are trying to help to facilitate alaska as well as enroll in alaska that
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has been set up for this. these are folks that want this to work. what i heard from them was stopped. it is not working. enroll29th of october, alaska confirmed that there was that hadhree alaskans successfully enrolled. there is nobody else that has confirmed that they have in thefully enrolled exchange from alaska. this is the fifth. he might have have somebody came in yesterday but as best as i can tell, it is three. in a letter that i received from enroll alaska, they confirm this and they have specific have specifically asked about the administration pulled the website down.
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one thing that was very disconcerting was to learn that perhaps the three that have been enrolled has been given incorrect information. it has discovered that they were talking late in the subsidy for alaskans incorrectly. therefore, they have suspended all in romans until the issue is resolved. this was last week. this subsidy calculator has been resolved. are you aware of this? has it been resolved? are we working on it? the concern is that not only can people not get onto enroll but if they do, the subsidy calculations are incorrect. >> so, we are aware, meaning the staff is aware of this issue and they are working on a fix to the system to correct the alaska issue.
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should alaskans do? should they stay off? >> i will get that information for you. >> what she did yesterday, i the exchanges will be 5f-line between 1 a.m. and a.m. eastern standard time until further notification. is that correct? is the window that we used to do software upgrades. that is why. >> ok. fair enough. might believe,e the son does not rise and set in washington, d.c. or on eastern standard time. when a family finishes up dinner, was the kids to bed in alaska, 9 a.m. is 1:00 a.m.. you have the time that alaskans would be able to sit and move
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through any aspects of this exchange, you are shut down. can you give me some indicator as to when this might be available for all americans to take a look at. >> we're in a situation where we have concerned with with the subsidy calculations in the state, we have maybe three people enrolled correctly. we are not sure, yet. we cannot get onto the exchanges when most people would have an opportunity to do so. i am having alaskans coming to me and saying, ok, it happens on january the fifth? i have an incident where i need my insurance. my insurance has been canceled. just about 60% of the folks who
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receive their insurance through our largest health insurance by a long margin have received their cancellation notices. so, you have that going on, you cannot get onto the exchanges. we are all saying that the exchange will get worked out. what they are coming to me and saying is if something happens to me and my family, that first week in january. if i had been able to apply for coverage, but for some reason, there is a glitch in the confirmation, getting my premium checked, if there is a health is at thejanuary, it individual that is on the hook? it hhs? will i beto know, taking care of, i don't have an
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answer for them. >> this is four hours of the day. >> i understand. >> it is very significant. thendividuals can go to call center and get help. that is true in alaska as well. if they want to submit paper applications, they can be processed and returned to them. >> what happens on january 1? who was on the hook? beforeill be resolved january 1. >> thank you. >> thank you, mr. chairman. thank you for holding this hearing. .hank you, administrator kavner i want to talk about massachusetts. everyone is frustrated by the first few weeks of and everyone is
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looking for answers. last week, president obama came to boston where he said health reform in massachusetts, like the affordable care act is not website, it is a value statement. the president is right. leaders in massachusetts like generations of national leaders fought for reform and health care. not because it was easy but because we all knew that the old system was broken. for years, costs exploded. too many consumers, patients, including those with insurance. a were threatened with financial ruin if they got sick. there has been a lot of comparisons between the aca rollout and our experience in massachusetts. what i can tell you all through the experience is that getting everyone into a new health care wasem wasn't easy and it
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not quick. in the first month, if people could sign up for subsidized coverage during our health reform launch in 2007, we got 123 people enrolled. because we were committing to making the law work into making sure that people have affordable health care, we kept working on it. we fixed the problems, we hit period lastedweour enrollment almost a full year. and yet it was only in the last total pool20% of the cut themselves and rolled. people signing up for nce had azed insura shorter time, and over 1/4 of them waited until the last month to get enrolled. i understand that the beginning -- butrollment period
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what we've learned in massachusetts is when it comes to enrolling in health care, any of us wait until the end to get it done. what didator tavenner, the administration anticipates would be the pattern, of enrollment, prior, what were you thinking prior to the launch of, and do you the early problems you had are moing to affect the long-ter pattern in enrollment? >> we assumed we would be able to enroll folks throughout the six months, but that that greatest surge would come in december, because we got there were people who wanted coverage on january 1 and the second search would come late february, early march, by the individuals who were not as motivated to get insurance.
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figures, butment they were lower for october him and i think they will be low, and it follows the massachusetts experience, and that was part of the reason for such a long and rome at period -- such a long enrollment period in the first year. >> and you have time to get these problems fixed? >> i think we have time. >> we agreed that the problems of the website are unacceptable, but our experience in massachusetts suggests it might be prudent for us to take a deep rest about this. -- a deep breath about this. the launch of our website was not smooth, but we kept working on it. when we had data mapping and volume problems during our launch in 2007, we kept working on it, and when we needed our
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tech surge to work on it, we kept working on it. we kept working on it because we stayed focused on what mattered -- our conviction that no one deserved to be bankrupted or shut out of the health care system when they got sick. so thank you, mr. chairman. >> thank you very much, senator warren. >> thank you, chairman. i would like to talk about my home state's experience. governor chafee, a republican member of this body, decided that early on that he was going to do this and get it right. stake, but weall are a pretty smart state, and he put christy ferguson, who some of the people might remember as thischafee's staffer on committee years ago, in charge of the project, and i want to say that in rhode island it has been a success. the first time that i went to visit i walked through the front door, it was late afternoon,
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5:30 or 6:00, to make sure that people could come in, and there was a family, mom, dad, three little kids, and they were at the reception desk, and they had just come in -- he had come in they hadn the day and been served and explained, walked through the whole process, and they were so thrilled with what they heard that they had gone out, and this was their return trip, with two bagboxes of "coffee and a of donuts, because they were so happy. i walked around and talked to people who were taking the calls and dealing with people over the computer him and one woman who was just beaming, and i asked her, you look like something wonderful just happened. you have quite a smile. she had just talked to somebody who was paying i want to say , and hadnth into cobra
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just found a better plan for $500 a month, and $300 a month is actually a pretty big deal in a family pot life, so she had had a really wonderful exchange with that person who had called in. we have people when they come in live, they are taken to private rooms to discuss it, and when people find out what the deal is, we have a lot of people who are getting hogs. the rize story today about a woman who burst into tears of joy's when she got coverage. i would like to have that "new york times" study put into the record. there is more than one story about this. rhode island is not a very big state. we made this work. it has worked pretty well. we had a glitch or the hull boys down and a couple hundred people could not get through. we're working through that. when i see these much bigger
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states who do not even try, they did not even try, and now everybody is complaining that the federal government did not do them well enough. there is a part of me that says, next time stand up and give it a try yourself. you know? you do not have to be just a recipient, and we are up nearly 4000 people and rolled -- enro caccounts.00 of all these wonderful stories. there is an another path, and we are sorry you had this much of the health care website rollout, but it should not mask that underneath it ere is a plan that is making a lot of families really happy, really, really happy. if you go to the front lines and go to your state exchange and see what people are seeing, you will see a lot of the stories.
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they are happening across the board. there is more to this. if you did not want to take the trouble to bother to set one up yourselves, it is a little nervously to be complaining that the government did not do it well enough when you could you had could do it if saddled up and done it. i would also -- there are these letters that people have been talking about the people have gotten. when we got this started, we were dealing with a health insurance industry that was so cold hearted that when is took a client who had been paying premiums for years and suddenly came in with a big claim, their first reaction was not how do we help this family, it was let's look at the records and see if we can find a way to disenroll them and get rid of this liability. they had acne. is that a pre-existing condition
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they did not this close to us? can we throw them off? that was the attitude. there were snazzy stuff that was happening to some of these letters. i want to use the example of rhode island who cross blue shield. it is a terrific letter. it is very clear that lays out what your choices are. it's as if you like what you got, you can keep it, and here is how, and it's as if you do not like it, if you want to use the exchange, here is how. it is three steps to stay in blue cross shield road island. it is three steps to get on the exchange. there is another way to do this. i think rhode island has done right, and we are seeing pretty low drama. good luck getting through this mess. it is been frustrating for all of us. but i think it is safe to say that across the river there are for us to go to.
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thank you, mr. chairman. >> thank you, senator white house. -- whitehouse. ms. tavenner, you have a hard time that you have to be out of here also. i want to make sure that people have five minutes and have a chance to ask another round. i would just say first of all i fork senator whitehouse mentioning rhode island. that will be put into the record. senator isakson asked for an i.t. report be made of the record. that will also be made part of the record. at theot mention that time. again, i like what senator said about this new affordable care act, or website, not not a about a website or some technical fix.
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it is a value system. do we like the old you system? where people could not get coverage? where somebody got sick, they would drop your policy, cancellations? i hear so much talk from the republican side about these cancellations. i did not hear much in the past when the buddies would automatically cancel you if you got sick. posse ifnot renew your you had cancer or breast cancer or something like that. did not hear about that. you are saying that is over with. that old value system was no good for this country, because too many people, like mr. streeter that i mentioned in the beginning, who was in the column on sunday, or i could mention kathleen ferguson of des moines, where eight years ago her son died at 30 sikkim and she said he died needlessly because he had a pre-existing condition and
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cannot get insurance and medication he needed. i want us to take better care of each other, and i'm grateful that people with pre-existing conditions can now get coverage. that is the old value system. a person from iowa wrote about her brother, then tried to find interest coverage for years. coverage with a $50,000 deductible, but nobody would give them a policy. when the exchange "he saved $700 a month on what he paid before. aca givestes that teh ache us a chance to avoid bankruptcy. there will be disruption when you move from an old system to a new system. certainly, we have to make sure that we fix these problems in the website and other things. i will refer again to what i param out security,
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ount. on, is one thing we agree that security is paramount in the system. the system itself, in terms of the system itself, it is going to work, it is going to be better for this country. i might say in terms of these cancellations, i love the rhode island letter. it was very clear. blue cross who shield sent a letter out and said do not worry, nothing is set in and they sent another page, you can either stay with us or go on the exchange. they said, do not worry, you have plenty of time. that is the cancellation notices. in the past, you know what a cancellation notice was? you are no longer eligible for insurance, good luck.
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that was the old cancellation notice. you have choices and options. again, i see the people have to take a deep breath and wait to understandople what is going on. now, i must say there was a story the other day in the paper about somebody who said now i got -- i have to take this policy that covers maternity care. my wife and i are not having any more children. why should i have to have a policy that covers maternity care? i got to thinking about that. i thought, you know what? and i doause my wife not have any more children and they are grown up, maybe i should not have to pay property taxes to pay for my local schools. huh? why should i worry about it? maybe only people who have kids going to the public school
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should pay for it. we are better than that in this country. we are talking about being part of our society. , my wifeour benefit and i, to support our local schools because that is our next generation, their want -- we want them well taught. same with health care. it is a values system. i am indebted to senator warren for mentioning that. no one will be left without insurance. no one will have to wait before they get advanced: or prostate or breast cancer before they can go to the emergency room and get help. that is the new value system. we are not turning back. fix the problems, move ahead, but let's aggressively get people enrolled in the system system of new value health care in america. i've used up my time, mr. alexander. tavenner,ou , ms.
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for being here today. the chairman is describing the --damental district fundamental differences we have had for the last four years. by expandingvolves this is that we already knew cost too much and the result is increasing premiums for millions, canceling insurance plans for millions, destroying relationships with doctors for millions, raising practices -- raising taxes by millions, spending money on new programs instead of investing in medicare to make it more solvent, and encouraging employers to work to have their employees work 30 hours and set of 40. that is not the values system that i support.
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we have a different approach, which would say let's encourage competition, let's encourage choices, and let's try to make health care cheaper so people can actually afford it. but that is our fundamental difference. venner, you, ms. ta don't you know with the improvements with a website how many people are trying to sign up every day for obamacare, how many are succeeding, what their level of insurance that they are buying is, don't you actually know that now? information that we are putting together and we will have available next week. >> next week? >> mid november. >> you're going to release it once? why don't you release a daily? >> we have said long before the program went live that we would to its similar to how do medicaid, medicare. >> this is different, these are
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people making decisions, people who will lose their insurance starting january, that have to sign up by december 15 -- >> that is all the reason to do it monthly, because people can decide to go in and out and have to decide to make payments until december. >> the people who need to know about it are the members of congress. let's say i'm a governor in a state that has not decided whether to respond medicaid. i want to know if 90% of going on medicaid or whether it is 80% or 70%. if we get a how many hamburgers and cars and records are being sold every day, why can't we know how many people are enrolling in obamacare? it is such a success, wouldn't that promote the success in the program, build confidence in the program? >> we will have that information next week. >> but that is once. why do we have it every day? you know it now, right? >> we are in the process of putting that information together. >> we are the congress and we
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are entitled to know answers to these questions so we can make our judgments about what to do. so our governors and consumers across america. >> i understand. as the example i used, emily from tennessee, isn't it true that the covered tennessee canceled by obamacare, the case of washington saying that insurance is not good enough so you cannot buy it anymore? >> i do not think it was canceled by obamacare. the insurance company made a decision to cancel up halsey -- a policy and offers of somethinng else. >> this is a letter from a state -- from the state this is covered tennessee will not be available starting january 1. this affects all covered tenn
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members. the new federal health care law will bring many changes, including new coverage options for tennessee. the obamacare said if the law had maximum limits, if you did not meet the standard for maximum limits, you cannot offer that insurance anymore. that is the law. it is case, for 60,000 people, obamacare said that insurance is not good enough for you and emily has to pay $6,000 more. >> we have been down this issue before. they could have been grandfathered in -- thehe law says that if state program does not meet the maximum limits, it is outlawed. does the law not state that? >> for new plans. i would have to -- >> for all plans -- >> there would be the opportunity for all plans to be grandfathere in. >> the law says if the plan does not eat the maximum limits, the
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plan cannot be offered -- >> you're talking about lifetime limits. >> that is correct. >> -i will be glad to- ed thatacare outlaw plan. why don't we put the president's word into law and say if you like your plan you can keep it. my time is up. thank you, mr. chairman. >> senator baldwin. >> thank you, and i thank you for staying around for a second round of questions. opportunity, first we were talking about the situation in the state of wisconsin. we are hearing a lot of people reference this idea if you like your insurance plan, you can keep it. in the state of wisconsin, a lot of people like badger care, but because of the decision of our governor, having nothing to do with what congress did years
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ago, 92,000 people who may really like their health care plan are being kicked off. because of this i really think it is a shared responsibility to figure out how to most effectively help these 92,000 people transition from badger enroll participate and in the federal exchange. i wanted to ask the companion questions, if there is a shared responsibility, what specific steps can the administration take to insure that these individuals are enrolled as soon as possible, but also that options are available to the state of wisconsin to eliminate the risk of losing this badger care medicaid coverage january 1? >> let me take that in reverse order. toconsin had the ability
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have expanded medicaid at no cost. about 25 states have elected to do medicaid expansion, including many republican states. but obviously wisconsin was not one of those very and so what we are trying to do is we are we will work with the state of wisconsin, with the medicaid office to identify those individuals and make sure they are aware of what is available on the exchange. there is a cost to that, so you get into the issues of subsidy and this sort of thing, but we will try to work with the state doubt these people, at least identify what is available to them. >> what sort of means? earlier, you asked sort of questions about how do you target young people? how do you target these 92,000 people , andr what is the state's role? >> obviously, the state knows
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who these individuals are, so they will be able to send them information. what we are doing is asking wisconsin to give us a plan on how they can do that. it is a shared responsibility. we will try to help. >> i would have to say as commentary before the exchange opened, a letter went out from the state, and you were mentioning that the state is aware of who these people are. it basically said someone in your household may eat on badger care and may be losing it. information in my mind is not adequate to assure have aople do not lapse in their coverage. my other question in my remaining time relates to the experiences of those states in the country in the early phases thisis articulate --
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marketplace, what is their experience versus states in the federal exchange like wisconsin in enrollment people, what comparisons can you make at this point, and can the 36 states that rely on exchange expects similar results when the technical issues with the website are fully worked out? >> yes, i think we would obviously expect similar results to what the states are seeing. i think we have released the formation around applications submitted. some states have talked about that publicly, and that is part of what we will release next week. if you look at texas, for the, statesare some large peop with people who are uninsured. >> with regard to the state-
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based exchanges, marketplaces, can you talk about any of the successes they have had or challenges in the early phases of enrollment? >> many of you have read about kentucky. kentucky has been a successful state. was on the medicaid side and on the exchange side. their governor has been obviously 100% behind this. he has led the effort. and so they have released numbers publicly, and i can get you those. washington was another, new york, california. of what willpart be reported next week. >> thank you, senator. >> thank you, mr. chairman. since you began a story, let me talk about mr. hood who lives close to me in north carolina. he now pays three and $24 a month for a plan with a $10,000 deductible. under the new law, the comparable plan for next year's just a paid 820 five dollars per
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month with an $11,000 family the peccable. their annual health payment would almost double from working thousand dollars to $24,000. and he is unlikely to be eligible for a subsidy. let me suggest that the reason that congress has covered this so thoroughly is this could be a hell of a lot easier. i would remind the chairman that dr. coburn and i came up with an alternate bill. we were denied the ability to amend on the floor of the united states senate and to offer an alternative. and that alternative took care of pre-existing conditions. it kept children on their insurance of their parents'. encompass many of the things that republicans and democrats alike about the affordable care act, but it did not get into a large top-down government- designed program that x winners
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and losers. and when you can have stories that are as passionate as yours and mine, clearly the system we have designed picks the winners and losers. it is not individuals americans who get to choose what they want, how much exposure or how much benefit. in other words, their health- care coverage matches their age, their health condition, and their pocketbook, and that is not what this does. let me ask you, what is the target enrollment for the end of november for the exchange? >> for the end of november? >> yes, ma'am. >> we were looking at between october and november, i think that number was i want to say around 800,000. insurersil 1 of 2014, urquhart to begin submitting bids for the 2015 plans. an extension was granted on
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enrollment to march 31. for many americans, they will not sign up until next year. considering that insurers will have no experience or very little to go on, which is to 2015,heir quotations on what accommodations will you make to make sure that insurers make informed decisions? >> the open enrollment period, we work in cooperation with insurers, so we think they will have the information necessary. between april 1 and april 27, 2014, they will have to submit their costs for their plans for the 2015 plan year? >> they would submit that over the second quarter of 2014, yes. >> without much experience of what the plan -- >> they will have the experience that they have had for the first four or five months, he yes. >> there are many people who are
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not required to sign-up until march 31. that is the month rental april. in other words, a day before they start submitting. you said earlier in your testimony that all the fixes done by cgi would be required without additional fees, and that is in a cost plus contract. can you assure the committee that there will be nothing on the plus side, that the federal government pays to cgi for their repairs on a website contract? >> the cost-plus contract is planned for or payment through march of 2014. so i am sure that that is a contract that they will operate under, yes. >> i am asking a very specific question. plus waste part of the contract. i am sure the plus aced deal with additional work done over the scope, over the stated scope
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of the contract clearly. fixing this exchange was not part of the contract. >> it is required, there were, in their existing contract. they have to fix their problems. >> know that many of us will be looking at the statements made on the plus side to see if in for theire paying cgi individuals to fix a website that they were contracted to produce for the federal government. again, i thank you for the work you've done on this. i know this is not fun to come up and answer the question. i would say the moral of the story is the more we share upfront, which we have not on the affordable care act, the more informed all members are. thank you, mr. chairman. much, senator.ry thank you very much for being here and being forthright in your answers. i thought this was a good session. i think you and your staff
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understand some concerns that both sides have on this. i think there were legitimately good questions pertaining to that aspect of it. of course, as my friend from tennessee points out, we still have philosophical differences on this issue. are some points to take on which both sides agree that we need to ensure, get fixed going forward, and i think we have started on those quite forthrightly. thank you very much, and as i said, the record will stay open 10 days for other statements and questions. thank you, ms. tavenner. the committee will stand adjourned. [captions copyright national cable satellite corp. 2013] [captioning performed by national captioning institute]
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>> the senate committee on health, education, labor and pensions will please come to order. ago, richardars streeter, a 47-year-old truck driver from oregon was frustrated and worried. as new york times columnist nicholas kristof described this weekend, mr. schrader could not find insurance in the individual market. no insurance company would cover him. he did what people locked out of the market do, he went without care. after months of ignoring care, for areeter went in
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colonoscopy, he could not afford one. the only one -- the only way he could get it was from a doctor who agreed to take half payment now and half when he could afford it. he had advanced: cancer -- advanced colon cancer. his doctor said this "it was heartbreaking to see the paint on his face, the real train wreck is what people are experiencing every day because they cannot afford care." mr. streeter is the second patient the doctor had put off seeing because of a lack of health insurance and now has advanced colon cancer. he has a tough road ahead of him, but now he does not have to worry about paying for treatment. he signed up for health insurance starting january 1, which cannot turn him down because of his pre-existing condition.
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we passed to the affordable care act so that this would never happen to another family. millions of americans are shopping on new health insurance marketplaces for coverage that starts next year. 700,000 people have filed applications. why is there a surge in interest? for the first time in history, their health, whether or not they have a chronic illness or had a back operation 10 years ago, will not prevent them from getting insurance. these reforms will deliver on a long-overdue promise to all americans. if you work hard and play by the rules and pay your fair share, you will never have to stay awake at night worried that you cannot afford to see a doctor or pay medical bills. it is a promise i wish we could have kept sumer -- sooner for mr. streeter. onwill hear a status report the implementation of these reforms. the rollout of the federal -- of the federal health insurance
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marketplace has been bumpy to put it mildly. consumers have run into roadblocks, the site has been functional one day, unresponsive the next. americans who have been waiting for years deserve better. secretaryent, sebelius, and our witness today have taken full responsibility for the technical flaws and the website and have said that no resource will be spared to fix the problem. i look forward to hearing an update today on those efforts. republican colleagues' concern about the technical flaws and the rollout. i look forward to a discussion about how we can move forward. but i want to be very clear. i hope we are clear for a discussion. i am as upset with anyone with the difficulties individuals on the federal marketplace are experiencing. i want to learn how those problems will be fixed.
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it may be a difference. i want it fixed so the affordable care act will succeed. down.ucceed, not be torn there are many who have spent the last three years doing nothing but trying to tear the slowdown. -- this law down. i feel they have surrendered their right to express indignation that they -- it is not working flawlessly. they had voted 32 times to repeal or defund the law. as an appropriator and chairs of the appropriations committee that funds the implementation of this law, my colleagues have denied implementation funds at every turn. they have try to stop navigators from set -- from spreading the word, sent letters to the national football league warning against reaching out to fans.
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governors and legislatures who ran on platforms of states rights handed over the responsibility of running the marketplace to the federal government. before we get into the details, everyone should take a deep breath. this is a website. this is a machine that will be fixed. americans have until the end of march next year to sign up. as the president said, the promise of the affordable care act is far more than just a website. to 105mise is a benefit million americans who have been 2010 againstce lifetime limits. for more than 3 million young people who can stay on a parents' policies until age 26. it is a benefit to seniors who have saved $8 million on prescription drugs -- $8
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billion. it is a benefit to the 71 million people in private insurance that have used preventative services at no cost, which mr. streeter could have used. hi this law then in effect to benefit. to the elderly americans with pre-existing conditions who cannot longer be denied or discriminated against by insurance companies. that is the big picture, and we should not forget it. health reform is the promise of the health and financial security that insurance companies bring. i can tell you that in iowa, iowa's premiums are among the lowest nationwide. a family of four making $50,000 will be able to get prompt level covers for $103 a month. toy $5,000ld making will be able to get a plan for less than $100. that is real choice, real
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affordability. let's get the website fixed as fast as possible so that every american can shop and and roll smoothly. but let's not forget the big -- that because of a obamacare, the affordable care act, millions of americans will not be in the same situation as mr. streeter found himself. about. what it is slowly but surely, americans who have waited years to get covered are enrolling in health insurance for the first time. we owe them our best efforts to move forward. closely whentening questions are asked of our witness. to help and fix the system so we can move forward to make this affordable care act work? to try tonother means tear it down and discourage participation? witness, thank our
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commissioner tavenner, for her leadership of the center for the care and medicaid services and for her dedication to making sure our health care system in america works for all. we will have some tough questions, that is fine. i do want to know why this problem cannot. -- came up. but i want to keep the big picture in mind as to what we're are doing here, that is to make the system work. i have one administrative this bei restrict that open for 10 days for statements to be submitted to the record. i turned to ranking member alexander. welcome ms., tavenner. i used to testify from that seat and i thought that the senators to literally put the chair down low so they could be of high --
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deliberately. kellye friend used to say story instead of making a speech. here is a story, 16,000 have coverage from a state program. obamacare is canceling their policies. example of what president obama calls bad apples, an insurance plan that is not good enough for you. i recently heard from one of those tennesseans whose policy will be canceled on january 1, her name is emily. she is 39 years old. she has lupus. she told me i cannot keep my current plan because it does not meet the standards of coverage. has is a travesty, coverten been a lifeline. with the discontinuation, i am being forced to purchase a plan to the exchange. i premiums alone will increase 410%.
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i out-of-pocket expense will increase by more than $6,000 a year, including subsidies. please help me understand how this is affordable, says emily. i were health care system makes up nearly 20% of our economy, touching the lives of every american. obamacare is pushing that 20% of our economy in the wrong direction. saidresident has repeatedly, i looked up the white house website this morning, "if you like your plan, you can keep it and you do not have to change due to the health-care law." that is the white house website that i -- today. as the president said, it is a law transforming our health care delivery system in the wrong more than a it is website, as the president said. it is a law transforming our health care delivery system in the wrong direction, we believe,
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by increasing premiums, canceling plans, strong relationships with doctors, raising taxes, forcing people $.5 medicaid, spending trillion on new programs instead of making medicare solvent and encouraging employers to reduce their employees catch three hours. then having the irs fine americans for failing to sign up on a website that does not work. the president promised you can keep your health care, but the ofn cancels millions individual policies. for millions of others, employees are -- employers are dropping insurance programs. the new promise is, if you want health care, go find it. on a website that the administration says will not be working properly until the end of november, that is an unlock him christmas present. two weeks to shop for insurance by december 15